City of Providence Providence Public School District Benefits - PowerPoint PPT Presentation

City of Providence Providence Public School District Benefits Division – 2020 Teacher Retiree Benefits Workshop Benefits Manager – Stacy Roberts Senior Benefits Analyst – Jennifer Charbonneau Benefits Specialist – Claire Girard Benefits Clerk – Toni Barletta

City of Providence Welcome! Congratulations on your retirement! Agenda – Pre 65 Benefits – Post 65 Benefits – Costs/Rate Letters – Frequently Asked Questions 2

City of Providence Who is eligible for retiree health coverage?  You!  Your legal spouse or ex-spouse*  Qualified Dependents (children up to age 26 and/or handicapped adult child*) * Certification/documentation required 3

City of Providence Summary of Pre-65 Health Coverage  Medical Only (Basic)  Medical + Prescription Drug Coverage  Medical + Prescription Drug Coverage + Dental Medical Prescription Drug Coverage Dental BCBSRI CVS Caremark Delta Dental - No Deductible -$1,200 max benefit per -$750 Deductible calendar year -$1,800 max benefit per calendar year - Existing coverage stays in effect until September 30, 2020 - Your retiree coverage is effective October 1, 2020 4

City of Providence Medical - Blue Cross Blue Shield of Rhode Island • Healthmate Coast to Coast – No Deductible – Refer to Benefit Summary provided – $0 Deductible Plan • Extensive PPO Network What’s Covered What You Pay In Network Primary Care Office Visits $10 per visit Specialist Office Visit $10 per visit Emergency Room Care $100 per visit Urgent Care Center $10 per visit Allergy & Dermatology $15 per visit Sample ID card 5

City of Providence Medical - Blue Cross Blue Shield of Rhode Island • Healthmate Coast to Coast - $750 Deductible – Refer to Benefit Summary provided • $750 Deductible (Individual) • $1,500 Deductible (Family) What’s Covered What You Pay In Network Primary Care Office Visits $30 per visit Preventative Care $0 per visit Specialist Office Visit $30 per visit Emergency Room Care $100 per visit Urgent Care Center $50 per visit Diagnostic lab, x-ray, imaging, high 0% after deductible end radiology Sample ID card 6

City of Providence Prescription Drug Coverage - CVS Caremark Healthmate Coast to Coast – No Deductible • Refer to CVS Benefit Summary provided and relevant CBA language Retail Pharmacy Network Generics $5 Preferred Brand $15 Annual Cap $600 Sample ID card 7

City of Providence Prescription Drug Coverage - CVS Caremark Healthmate Coast to Coast - $750 Deductible • Refer to CVS Benefit Summary provided and relevant CBA language Retail Pharmacy Network Generics $5 Preferred Brand $15 Non Preferred $30 Brand Sample ID card 8

City of Providence Dental – Delta Dental of RI-Retired Teachers Refer to Dental Benefit Summary - $1,200 Annual Maximum per member per year - Get a Pre-treat estimate! Procedures Plan pays 100%: • Oral Exam (1 per year) • Cleaning (2 per year) • Bitewing X-rays (1 set per year) • Amalgam Fillings (silver) Plan pays 50%: • Bridges, build ups, posts, cores • Crowns over implants • Partial & complete dentures • Single Tooth Implants Sample ID card 9

City of Providence Dental – Delta Dental of RI-Retired Teachers Refer to Dental Benefit Summary - $1,800 Annual Maximum per member per year - Get a Pre-treat estimate! Procedures Plan pays 100%: • Oral Exam (1 per year) • Cleaning (2 per year) • Bitewing X-rays (1 set per year) • Amalgam Fillings (silver) Plan pays 50%: • Bridges, build ups, posts, cores • Crowns over implants • Partial & complete dentures • Single Tooth Implants Sample ID card 10

City of Providence Frequently Asked Questions (Pre-65) Q - How will you know what your rate will be in October? A - You will receive a rate letter in the mail in June with coupons that show the new rate. Q - When is my payment due? A - Payment is due by the 15 th of each month. (If at any point, you run into a financial hardship, you may contact the Benefits Office to arrange a payment plan.) Q - How do I pay my monthly payments? A - You will need to send a check or money order to us (made payable to Providence School Department) each month to our confidential PO Box (Attn: PPSD Retiree PO Box 1656, Providence, RI 02901). Q - Can I pay more than one month at a time? A - Yes, you may pay more than one month in advance. On the memo portion of your check please write in which months you are paying and your Account number that is listed on the payment coupon. Q - When do I need to return applications for coverage or the deferral form? A - You should return all applications and/or deferral form to the Benefits Office 30 days prior to the effective date of retiree coverage (August 31 st or as soon as you are confident in your decision). 11

City of Providence Summary of Post-65 Health Coverage  Medicare Part A – Hospital Insurance - no cost  Medicare Part B – Medical Insurance - $144.60 per month (social security check)  Medicare Part C – Medical Supplement – City Options - Plan 65 or Blue Chip  Medicare Part D – Prescription Coverage – City Option - Blue Medicare Rx (Group PDP) OR Medicare Part D – Prescription Coverage – BCBSRI Individual Options – Blue Medicare Rx Individual Plans or Open Market Medical Supplement Prescription Drug Dental Coverage Plan 65 or Blue Chip Blue Medicare Rx Delta Dental - Existing coverage stays in effect until September 30, 2020 - Your retiree coverage is effective October 1, 2020 12

City of Providence Blue Chip for Medicare Plan 65 Medicare Advantage Plan – Group Plus Option Medicare Supplement Plan Instead of Original Medicare In Addition to Original Medicare Enhanced skilled nursing care benefit Basic Medicare skilled nursing care benefit Includes: Prescription Drug Coverage, Certain Dental Does NOT Include: Prescription Drug Coverage, Dental Services, Vision Benefit Services, Vision Benefit PCP Co-Payment: $0 - $10 PCP Co-Payment: $0 Specialist Co-Payment: $30 Specialist Co-Payment: $0 Hospitalization: $250 per admission Hospitalization: $0 per admission Skilled Nursing Facility: $0 each day for day 1-29; $50 Skilled Nursing Facility: $0 each day for day 1-20; $170.50 each day for days 30-100 each day for days 21-100; 100% of cost for days 101+ Home Healthcare: $0 Home Healthcare: $0 Durable Medical Equipment: $0 Durable Medical Equipment: $0 Diagnostic Lab/X-Ray Services: $0 Diagnostic Lab/X-Ray Services: $0 MRI/CT Scan/PET Scan (w/ Pre-Authorization): $50 MRI/CT Scan/PET Scan: $0 Outpatient Hospital: 20% Outpatient Hospital: $0 Emergency Room: $65 (waived if admitted w/in 1 Day) Emergency Room: $0 Urgent Care: $40 Urgent Care: $0 13 Out-Of-Pocket Maximum : $3,000 Out-Of-Pocket Maximum: N/A

City of Providence Blue Cross Individual Part D Offerings - Effective January 1, 2020 - December 31, 2020 Blue MedicareRx Value Plus* Blue MedicareRx Premier* Blue MedicareRx Group Plus (PDP)** Drug Tier *Not sponsored by the City of Providence – *Not sponsored by the City of Providence – **Group Plan – sponsored by the City of Providence Individual plan only Individual plan only Monthly Premium $42.50 $128.00 $209.00 $0 (Tiers 1 & 2) Annual Deductible $0 $0 $435 (Tiers 3, 4, & 5) Standard Retail Mail-Order Network Retail Initial Coverage (30 day) (90 day) Network Retail Network Retail Network Retail Pharmacy with Level Pharmacy with 90-day Pharmacy with Pharmacy with Standard 90-day supply Preferred Cost- supply Mail- Preferred Cost- Standard Cost- Tier 1 Generics - $10 Tier 1 Generics - $10 Cost-Sharing Mail-Order You pay the following Sharing 30-day Order Sharing 30-day Sharing 30-day Tier 2 Brand - $20 Tier 2 Brand - $40 30-day supply until your annual supply Retail supply Retail supply Retail Tier 2 Specialty - $20 Tier 2 Specialty – N/A Retail prescription drug costs for covered $2 / $8 / $37 $7 / $19 / $47 / $2 / $16 / $74 $1 / $7 / $30 / $6 / $12 / $40 / $1 / $14 / $60 / drugs reach $4,020 $10 / $20 $10 / $40 40% / 26% 50%/ 26% / 40% / N/A 35% / 33% 45% / 33% 35% / N/A For covered generics in Tiers 1 & 2 you pay: Coverage Gap There is no coverage gap for this plan For covered generics , you pay: 37% of costs $1 / $7 30-Day $6 / $12 30-Day After your total yearly drug costs reach $4,020 or the Between $4,020 in Supply Retail Supply Retail with $1 / $14 90-Day coverage gap, your copayments, and monthly premium For covered brands , you pay: 25% of annual drug costs with Preferred Standard Cost- Supply Mail-Order will remain the same as outline above. Your copayments negotiated price and Cost-Sharing Sharing will not change until you qualify for catastrophic coverage (excluding the dispensing fee) $6,350 in annual For covered generics in other tiers you pay 37% of out-of-pocket costs costs For covered brands , you pay 25% of negotiated price Catastrophic Coverage Level You pay greater of: You pay greater of: You pay greater of: After yearly out-of- • $3.60 or 5% - generics or brands treated like • $3.60 or 5% - generics or brands treated like • $3.60 generics or brands treated like generics pocket drug costs generics generics • $8.95 all other drugs reach $6,350 • $8.95 or 5% - all other drugs • $8.95 or 5% - all other drugs 14